T S Vijayan, Chairman, Insurance Regulatory & Development Authority of India (IRDAI) has underscored the need to devise health insurance products that are simple and intelligible to the customers, provide coverage to the aged and infirm and those suffering from chronic ailments, bring down distribution costs and ensure that there is no profiteering to the detriment of the insured.
Vijayan said the goal of achieving inclusive, accessible and affordable health insurance by 2025 was laudable and was in keeping with the millennium development goals. To this could be added another aim, that of responsibility and responsiveness in the delivery of health insurance service as suggested by Dr. Sanjaya Baru, Secretary General of FICCI.
Vijayan said that the time was perhaps ripe to look at introducing community group insurance products to bring down distribution costs and determining the genuineness of health insurance claims. The veracity of claims by an insured person could be verified through members of a community or group so that insurance companies were not unnecessarily burdened with fictitious claims.
The IRDAI chief also underlined the need for standardization of costs of healthcare from one hospital to another in a city. This analysis could be done procedure-wise in a particular city to allow the insured to opt for a hospital of his choice.
Vijayan spoke of the need to bring down out of pocket expenses of patients, currently reckoned at 62% of all healthcare costs. This was extremely high and leads to impoverishment of the patients, he said. In comparison, out of pocket hospital expenses in developed countries such as the US and UK were 20% and in BRICS countries about 20-25%.
On the occasion, Vijayan released three knowledge papers — FICCI-KPMG Knowledge Paper on ‘MSME Group Health Insurance Penetration in India’, FICCI-KPMG Knowledge Paper on ‘Health Savings Account in India’ and  FICCI-EY Knowledge Paper on ‘Distribution2.0 – Improving Distribution in Health Insurance’.
In his Theme Address, G Srinivasan, Chairman, FICCI Health Insurance Committee and Chairman & Managing Director, The New India Assurance, said that while life expectancy in India has gone up significantly, the disease burden is still very high. The health insurance penetration was abysmally low in India at 30% and therefore there was a long way to go. Dr. Sanjaya Baru, said that there was a need to address the anxiety of the customers as they avail of the benefits of health insurance since many remain in the dark with regard to costs and the services offered to them. He therefore stressed the imperative of responsibility amongst healthcare providers in dealing with patients.


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